[Principles and elaboration of a vestibular rehabilitation technic, vestibular habituation training]

In the scope of the treatment of some vertiginous patients, the vestibular habituation training has to be considered as a valuable technique, superior to the merely medical treatment by drugs. Bsed on the fundamental principles of the vestibular physiopathology, its aim is to favour the compensatory and adaptive functions of the vestibular regulation centres in case of a peripheral dysfunction, either a unilateral hypofunction or some type of paroxysmal positional vertigo. The repeating of the provoking manoeuvres results in a habituation effect, so that the centres accept this abnormal stimulation pattern and are able to transform it in an equilibrated elaboration of the reflexes. In this way, every dizzy sensation can be abolished. So each case presenting provoked dizziness, either on the base of unilateral vestibular hypofunction, or as a typical paroxysmal positional vertigo, can be treated in this way. The patients are selected by anamnesis and thorough functional evaluation with search for positional nystagmus, caloric and rotation tests, recorded by E.N.G. Afterwards movements and positions provoking dizziness are tested in a practical way, leading to a selection of movements which are used in order to compose the treatment schedule. This test battery permits also to realize a close and precise follow-up of these patients, besides the classical clinical and E.N.G. evaluations. A preliminary report of 62 cases is presented. We found a positive result in more than 2/3 of the cases after 2 months. This technique being subject of further intensive investigations in our department, we make reservations as to future changes in the technique and procedures presented in this study. We would like to emphasize this treatment has to be integrated in a global clinical approach to the dizzy patient.